Comparison of Post-operative Mean Opioids Consumption in Patient given Preoperative Gabapentin and Placebo Undergoing Major Laparotomies for Lower Abdomen and Pelvis

Objective:- To compare the efficacy of lignocain with lignocain and magnesium sulfate for intravenous regional anesthesia. Material and methods:- This Ranodomized controlled trial was conducted at Bahawal Victoria Hospital, Bahawalpur and Nishtar Hospital Multan. The patients were divided in two equal groups. In group L, 55 patients received Lignocain alone and in group M, 55 patients received lignocaine with magnesium sulfate. The two groups were compared for the efficacy. Results:- Mean VAS was 4.36 + 2.40 in group L and 3.55+ 2.47 in group M (p>0.05). The efficacy of lignocaine alone was observed in 21 (38.2%) patients while efficacy of lignocaine with magnesium was seen among in 32 (58.2%) patients. p-value > 0.05. Conclusions:- The use of magnesium along with lignocaine is found to be more effective than lignocaine alone for IVRA.   Key words:- Intravenous regional anesthesia; lignocaine; magnesium sulfat

FREQUENCY AND RISK FACTORS ASSOCIATED WITH THE TRANSMISSION OF HEPATITIS B AND HEPATITIS C VIRUS INFECTION IN PREGNANT WOMEN OF SOUTH PUNJAB.

Objective:- To see the frequency of Hepatitis B and Hepatitis C virus infection and associated risk factors  in pregnant women. Study design:- Cross-sectional study. Setting:- Outpatient departments of Gynaecology and obstetrics, Nishtar hospital Multan and Bahawal Victoria Hospital (BVH) Bahawalpur. Patients and methods:- A total of 500 pregnant women attending outpatient departments of Gynaecology and Obstetrics were included in this study. Informed consent was taken. A specially designed proforma was filled in. HBsAg and Anti-HCV were tested by device method. Data were analyzed on SPSS-20. Results:- Out of 500 pregnant women 35(7.00%) were found to have Anti-HCV positive and 23(4.60%) were positive for HBsAg. Mean age of the study cases was 26.7± 4.8 years. Majority of the patients 263(52.60%) were from age group 26-35 years. In this study 138 (27.60%) of women were nulliparous and 282 (56.40%) were para 1-4 and Hepatitis B and C were common in this parity group. Only 80 (16.00%) women were para 5 or more. All Hepatitis B and C positive women were house-wives. Most of them were belonging to rural areas and with poor socio-economic status.  Among 35 anti-HCV positive women, 20 (57.14%) had history of previous surgery while 13 (37.14%) had history of multiple injections, 5 (14.28%) received blood transfusion, 4 (11.42%) had ear/nose piercing while tattooing was seen in only 2 (5.71%). Among 23 HBsAg positive women, 10 (43.47%) had history of previous surgery. History of Multiple injections was present in 6 (26.08%) patients, 4 (17.39%) patients had history of blood transfusion, Tattooing, Ear/nose piercing, history of dental procedure, history of sharing needles was observed in 1 each. Conclusion:- HCV infection is more common than HBV infection in our study population. Previous History of surgery, multiple injection therapy and blood transfusion are major risk factors. Keywords:- Hepatitis B, Hepatitis C, Risk factors,  Pregnancy

Optimized production of tannase and gallic acid from fruit seeds by solid state fermentation

Purpose: To investigate the possibility for gallic acid production from different tannin-rich fruit seeds using Aspergillus oryzae via solid-state fermentation. Methods: Fruit seeds of apple, guava, tamarind, black plum and watermelon were analyzed to estimate the synthesis of an enzyme tannase and its product gallic acid. Various physicochemical parameters were optimized to increase the gallic acid yield. Gallic acid was extracted by Soxhlet apparatus and identified by Fourier-transform infrared spectroscopy (FTIR). It was quantitatively determined by high performance liquid chromatography (HPLC). Results: Amongst the various substrates tested, black plum seeds gave the highest activity of 34.40 U/g for tannase and 16.66 mg/g for gallic acid under optimized physicochemical conditions, i.e., 1:3 substrate: moisture ratio, 30 °C, 96 h incubation period and pH 5.5. Addition of carbon source had a negative effect on production while ammonium sulphate (0.2 %) as nitrogen source increased the yield of both products. The gallic acid produced was 98.5 % pure, compared to the standard. Conclusion: Production of tannase and gallic acid via solid-state fermentation conditions has been optimized in vitro. The optimized conditions can be utilized on a commercial scale for economically viable production of gallic acid

Empirical Analysis of Farmers Preferences and Willingness towards Organic Farming in Gilgit-Baltistan, Pakistan

Background: Organic farming is an eco-friendly approach in the agricultural production system that ensures food safety, reduces health problems, promotes environmental conservation, and generates employment opportunities for local communities.Methods: The survey was conducted using a well-structured questionnaire that focused on the scope and potential of organic farming in Gilgit-Baltistan (GB), Pakistan. The data were collected from randomly selected 150 respondents in nine districts of GB between May and June (2019). This survey analyzed the factors influencing the willingness of farmers to pay attention to organic farming and evaluated the possibilities of espousal organic farming as an effective approach.Results: In general, mixed perceptions were revealed by the behavior and attitudes of the farmers, however, it is necessary to notice the intentions of the farmers for substitute methods to make organic farming feasible. Based on the survey, people were not reluctant to adopt organic farming to ensure better market value for their products. As a result, they will sustainably get a better livelihood.Conclusion: The current study is concluded that the espousal of organic farming could have a positive and noteworthy outcome on a farmer’s life in terms of profitability, compatibility, productivity, and sustainability in GB. There is a dire need for organic certification to increase the market value both at local and international levels.Keywords: Gilgit-Baltistan; Eco-friendly; Organic farming; Practices; Survey

Catalogues of Efficient Minimal Weakly Balanced RMDs in Circular Periods of Three Different Sizes

In this article, efficient minimal circular weakly balanced RMDs are constructed for the situations where these designs cannot be constructed through generators. Catalogues of these efficient designs are compiled in periods of three different sizes. In the proposed designs, v/2 ordered pairs of distinct treatments do not appear as their preceded value while the remaining ones appear once, where v is number of treatments to be compared

Phytochemical and antioxidant potential of selected plants from Mianwali, Pakistan

Plants have been used since ancient times as an important source of biologically active substances. Specific activities of these plant extracts are generally linked to the presence of secondary metabolites together with their phenolic contents. Present study aimed at investigating the total phenolic and flavonoid contents, and antioxidant activity of selected plants from five different families. The total phenolic content was measured using Folin-Ciocalteu assay and total flavonoid content by aluminum chloride colorimetric method. The antioxidant capacity was estimated by phosphomolybdinium assay. Our findings indicates that total phenolic content for methanolic extracts ranged from 27.07 to 59.11 mg GAE/g DW, and total flavonoid content ranged from 38.37 to 124.23 mg QE/g DW, with an antioxidant activity ranging from 55.82 to 129.06 mg AAE/g DE. Following trend was shown in the assessment of total phenolic and flavonoid contents: Rhazya stricta>Cicer arietinum>Solanum melongena>Solanum surattense>Solanum nigrum>Withania sominifera>Sisymbrium irio>Withania coagulans>Raphanus sativus>Fagonia indica>Brassica napus. While the antioxidant capacity followed the trend: Cicer arietinum>Solanum nigrum>Withania coagulans>Rhazya stricta>Raphanus sativus>Solanum melongena>Withania sominifera>Solanum surratense>Fagonia indica>Brassica napus>Sisymbrium irio. It is also seen that both wild and cultivated plants have higher medicinal value, which can be linked to the phenolic and flavonoid content, and antioxidant potential. Findings of the study revealed that wild plants possess higher phenolic content compared to cultivated plants, whereas cultivated plants had higher antioxidant activity

Exploring the effects of noise pollution on physiology and ptilochronology of birds.

Short and long-term sound-induced stress on daily basis can affect the physiology of avian individuals because they are more susceptible to sound stress in an open environment.ObjectivesAn ex-situ study was carried out to determine the impact of noise on physiology and ptilochronology of non-breeding male domesticated quail birds.MethodologyDuring 60-days long trial, male quail birds, aged 5-weeks, weighing (c.100gm) were used. Out of 72 experimental birds, 18 birds were assigned to the Control Group (G1) while remaining 54 birds were divided equally into 3 treatment groups: Road Traffic noise (G2), Military activity noise (G3) and Human Activities noise (G4). Birds were housed in standard-sized separate cages (20 ×45 × 20 cm), every bird was kept apart in separate cage in open laboratory under maintained environmental conditions. Millet seeds and water were provided to all the experimental birds ad libitum. Noise originated from several sources of recorded high-intensity music (1125 Hz/ 90 dB), was administered for 5-6 hours per day. Observations were recorded in the morning and afternoon. The experiment was conducted during the non-breeding season from August to October in triplicate. Blood sampling was done after 60 days.ResultsAccording to the current study, noise stress significantly (pConclusionNoise stress can significantly affect serology, hematology, hormonal physiology and ptilochronology in quail birds

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity &gt; 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI